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Paediatric Laboratory Medicine

Cyclosporine

Clinical Significance

Cyclosporine (cyclosporin A, CsA), is an immunosuppressant that is used to prevent or treat organ rejection for kidney, liver, heart and bone marrow transplants. Cyclosporine is also used for the treatment of Rheumatoid Arthritis, Psoriasis, Inflammatory Bowel Disease, Nephrotic Syndrome and many autoimmune based diseases. The drug, a metabolite of the fungus Beauveria nivea, is a small polypeptide containing 11 amino acids. While cyclosporine has immunosuppressant properties, the exact mechanism of action is unknown. It appears that cyclosporine inhibits the release and production of interleukin-2, which is needed for the induction of T-lymphocytes. T-lymphocytes are the primary contributors to the immune response that causes the body to reject transplanted organs.

Nearly 50 per cent of patients taking cyclosporine experience hypertension. Less frequently occurring side effects include: gastrointestinal abnormalities (abdominal discomfort, dyspepsia, nausea), hepatotoxicity, hyperlipidemia, hyperkalemia, hypomagnesemia, CNS disturbances, hyperglycemia, and infection.

Test Name

Cyclosporine

Alternate Name/ Synonym

Neoral

Test Code

CSA

Drug Class

Immunosuppressive

Division

Therapeutic Drug Monitoring - TDM

Method

LC-MS/MS

External Proficiency Testing

CAP

Turn Around Time

Daily @ 10:30h

Disease/Condition

Immunosuppressive

Specimen Type

Whole Blood (EDTA) - Do not separate

Minimum Specimen Requirements

200 uL

Optimal Collection Time

Trough: 0-30 minutes prior to dose

Storage/Transportation

4°C (transport with a cool pack if possible)

Approval is not required

CPT Codes

80158

Shipping and Contact Information

The Hospital for Sick Children
Rapid Response Laboratory
170 Elizabeth Street, Room 3642
Toronto, ON
M5G 2G3
Canada
Phone: 416-813-7200
Phone: 1-855-381-3212

Therapeutic Range

Transplant site dependent